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Package Leaflet: Information for the user

(fluticasone propionate)

Using this medicine

Flixotide Accuhaler is available in the following strengths: 50 mcg, 100 mcg, 250 mcg, 500 mcg.
This leaflet only applies to Flixotide 250 microgram Accuhaler/Fluticasone Propionate 250
microgram Accuhaler but will be referred to as Flixotide Accuhaler throughout this leaflet.
Read all of this leaflet carefully before you start taking this medicine because it
contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor, nurse or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm
them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor, nurse or pharmacist. This includes any
possible side effects not listed in this leaflet. See section 4.

The usual starting dose is 100 micrograms twice a day.

Moderate to severe asthma

The usual starting dose is 250 to 500 micrograms twice a day.
The most taken should be 1000 micrograms twice a day.

Children (4 to 16 years of age)

The usual starting dose is 50 micrograms twice a day.
The most taken should be 200 micrograms twice a day.

Flixotide 250 micrograms Accuhaler is not recommended for children 16 years and under.
It is recommended that children being treated with steroids, including Flixotide Accuhaler have
their height checked regularly by their doctor.
Your doctor may give you a Flixotide Accuhaler of a higher strength if your dose is increased.


If you are using high doses of an inhaled steroid for a long time you may sometimes
need extra steroids for example during stressful circumstances such as a road traffic
accident or before an operation. Your doctor may decide to give you extra steroid
medicines during this time.

Flixotide Accuhaler is a plastic inhaler device containing a foil strip with 60 blisters. Each blister
contains 250 micrograms of the active ingredient fluticasone propionate.
Fluticasone propionate belongs to a group of medicines called corticosteroids (often just called
steroids). A very small dose of steroid is needed when it is inhaled. This is because it is inhaled
straight to your lungs.

Patients who have been on high doses of steroids, including Flixotide Accuhaler for a
long time, must not stop taking their medicine suddenly without talking to their
doctor. Suddenly stopping treatment can make you feel unwell and may cause
symptoms such as vomiting, drowsiness, nausea, headache, tiredness, loss of
appetite, low blood sugar level and fitting.

Flixotide Accuhaler works by reducing swelling and irritation in the lungs. It has what is called
an ‘anti-inflammatory action’.
Flixotide Accuhaler helps to prevent asthma attacks in people who need regular treatment. This
is why it is sometimes called a ‘preventer’. It needs to be used regularly, every day.

Instructions for use

Flixotide Accuhaler will not help treat sudden asthma attacks where you feel breathless.
• A different medicine is used for treating sudden attacks (called a ‘reliever’).
• If you have more than one medicine, be careful not to confuse them.


The medicine in Flixotide Accuhaler should be inhaled using a special kind of inhaler called an
• Make sure that you have one and can use it properly
• Instructions on how to use the inhaler are given as a step-by-step guide
• You should be able to taste the powder on your tongue if you have taken it correctly
• It takes a few days for this medicine to work and it is very important that you use
it regularly.

Adults and Children over 16 years of age
Mild asthma

What is in this leaflet:
1. What Flixotide Accuhaler is and what it is used for
2. What you need to know before you use Flixotide Accuhaler
3. How to use Flixotide Accuhaler
4. Possible side effects
5. How to store Flixotide Accuhaler
6. Contents of the pack and other information


Flixotide Accuhaler comes in four different strengths. Your doctor will have decided which
strength you need. Always use this medicine exactly as your doctor has told you. Check with
your doctor, nurse or pharmacist if you are not sure.


Your doctor, nurse or pharmacist should show you how to use your inhaler. They should
check how you use it from time to time. Not using the Flixotide Accuhaler properly or as
prescribed may mean that it will not help your asthma as it should.
The Accuhaler is provided in a sealed foil wrapper. The wrapper provides protection from
moisture and should only be opened when you are ready to use it for the first time. Once
opened the foil wrapper should be discarded.
The Accuhaler device holds blisters containing Flixotide Accuhaler as a powder.
There is a counter on top of the Accuhaler which tells you how many doses are left. It
counts down to 0. The numbers 5 to 0 will appear in red to warn you when there are only a
few doses left. Once the counter shows 0, your inhaler is empty.

Do not use Flixotide Accuhaler:

Warnings and precautions

Do not use your inhaler more often than the doctor told you to. Tell your doctor if your medicine
does not seem to be working as well as usual, as your chest problem may be getting worse and
you may need a different medicine.

If you are allergic to fluticasone propionate or any of the other ingredients of this medicine
(listed in Section 6).
Do not use Flixotide Accuhaler if any of the above applies to you. If you are not sure, talk to
your doctor, nurse or pharmacist before using Flixotide Accuhaler.

Talk to your doctor, nurse or pharmacist before taking Flixotide Accuhaler if:
• you have ever been treated for tuberculosis (TB).
• you are using Flixotide Accuhaler at the same time as taking steroid tablets. Also if you have
just finished taking steroid tablets. In both cases, you should carry a steroid warning card
until your doctor tells you not to carry one.
If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before
using Flixotide Accuhaler.

Your doctor may have told you to take more than this as an emergency treatment if your
wheezing or breathing gets very bad. It is very important that you keep to your doctor’s
instructions as to how many blisters to take and how often to use your inhaler.

Using your inhaler

Inside the carton, your Accuhaler is provided in a sealed foil wrapper. To open this
wrapper, tear along the jagged edge, then remove the Accuhaler, and throw the wrapper
away. If you have trouble tearing the foil, do not use scissors or any other sharp objects as
you may harm yourself or the Accuhaler. Ask someone to help


To open your Accuhaler, hold the outer case in one hand and
put the thumb of your other hand on the thumbgrip. Push your
thumb away from you as far as it will go. You will hear a click.
This will open a small hole in the mouthpiece.


Hold your Accuhaler with the mouthpiece towards you. You can
hold it in either your right or left hand. Slide the lever away
from you as far as it will go. You will hear a click. This places a
dose of your medicine in the mouthpiece.
Every time the lever is pulled back a blister is opened inside
and the powder made ready for you to inhale. Do not play with
the lever as this opens the blisters and wastes medicine.


Hold the Accuhaler away from your mouth, breathe out as far as is comfortable. Do not
breathe into your Accuhaler. Do not breathe in again yet.

Other medicines and Flixotide Accuhaler

Tell your doctor, nurse or pharmacist if you are taking, have recently taken or might take any
other medicines, including medicines obtained without a prescription. This includes herbal
medicines. Remember to take this medicine with you if you have to go into hospital.
In particular tell your doctor or pharmacist if you are taking any of the following:
• a type of antiviral medicine known as a ‘protease inhibitor’ (such as ritonavir) or cobicistat
containing products which may increase the effects of fluticasone propionate. Your doctor
may wish to monitor you carefully if you are taking these medicines.
• medicines used to treat fungal infections (such as ketoconazole).
If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before
using Flixotide Accuhaler.

Using Flixotide Accuhaler with food and drink

You can use Flixotide Accuhaler at any time of day, with or without food.

Pregnancy and breast-feeding

If you are pregnant or are breast-feeding, think you may be pregnant or planning to have a
baby, ask your doctor for advice before taking this medicine.

Driving and using machines

Flixotide Accuhaler is not likely to affect you being able to drive or use any tools or machines.

Flixotide Accuhaler contains lactose

Flixotide Accuhaler contains lactose (a type of sugar). If you have been told by your doctor that
you cannot tolerate or digest some sugars (have an intolerance to some sugars), talk to your
doctor before using this medicine.

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Talk to your doctor as soon as possible if:

Put the mouthpiece to your lips; breathe in steadily and deeply
through the Accuhaler with your mouth, not through your nose.
Remove the Accuhaler from your mouth. Hold your breath for
about 10 seconds or for as long as is comfortable. Breathe out

after 7 days of using Flixotide Accuhaler your shortness of breath or wheezing does not get
better, or gets worse.
you or your child is on high doses of inhaled steroid and become unwell with vague
symptoms such as tummy ache, sickness, diarrhoea, headache or drowsiness. This can
happen during an infection such as a viral infection or stomach upset. It is important that
your steroid is not stopped suddenly as this could make your asthma worse and could also
cause problems with the body’s hormones.

Reporting of side effects


If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible
side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card
Scheme at: or search for MHRA Yellow Card in the Google Play
or Apple App Store. By reporting side effects, you can help provide more information on the
safety of this medicine.

To close the Accuhaler, slide the thumbgrip back towards you,
as far as it will go. You will hear a click. The lever will return to
its original position and is reset.
Your Accuhaler is now ready for you to use again.
Afterwards, rinse your mouth with water and spit it out.


Cleaning your Accuhaler

Wipe the mouthpiece of the Accuhaler with a dry tissue to clean it.

If you use more Flixotide Accuhaler than you should

If you use more than you should, talk to your doctor as soon as possible.
It is important that you take your dose as stated on the pharmacist’s label or as advised by your
doctor. You should not increase or decrease your dose without seeking medical advice.

If you forget to use Flixotide Accuhaler

If you stop using Flixotide Accuhaler


Take the next dose when it is due.
Do not take a double dose to make up for the forgotten dose.
Do not stop treatment even if you feel better unless told to do so by your doctor.


What Flixotide Accuhaler contains

The active substance is fluticasone propionate.
The other ingredient is lactose.

If you have any further questions on the use of this medicine, ask your doctor, nurse or



Keep your Flixotide Accuhaler out of the sight and reach of children.
Do not store above 30°C.
Store in a dry place to protect from moisture.
Store the Accuhaler in the foil wrapper until you are ready to use it for the first time. Once
opened, the foil wrapper should be discarded.
Do not use after the date shown as 'EXP' on the carton and device. The expiry date refers to
the last day of that month.
If the device doesn't appear to be working properly, or is damaged, consult your pharmacist
for advice.
If you are told to stop taking this medicine, return your Flixotide Accuhaler to your
pharmacist to be destroyed.
Medicines should not be disposed of via wastewater or household waste. Ask your
pharmacist how to dispose of medicines no longer required. These measures will help to
protect the environment.

What Flixotide Accuhaler looks like and contents of the pack


Like all medicines, this medicine can cause side effects, although not everybody gets them.
If you notice any of the following serious side effects, stop using this medicine and
talk to your doctor straight away. You may need urgent medical treatment.
• allergic reactions (may affect up to 1 in 100 people) – the signs include skin rashes,
redness, itching or weals like nettle rash or hives
• severe allergic reactions (may affect up to 1 in 10,000 people) - the signs include swelling of
your face, lips, mouth, tongue or throat which may cause difficulty in swallowing or
breathing, itchy rash, feeling faint and light headed and collapse
• your breathing or wheezing gets worse straight after using your inhaler.

Your Flixotide Accuhaler is a two tone orange and brown colour, circular device in moulded
plastic containing inhalation powder and with a dose counter indicating number of doses
Flixotide Accuhaler is a plastic inhaler device containing a foil strip with 60 blisters. The device is
provided in a sealed foil wrapper. Each blister contains powder for inhalation containing 250
micrograms of the active ingredient fluticasone propionate. Your medicine also contains lactose
which acts as the carrier. The blisters protect the powder for inhalation from the effects of the
atmosphere. The device has a counter which tells you the number of blisters remaining. It
counts down from 60 to 0. To show when the last five blisters have been reached, the numbers
appear in red. When the counter shows 0, your inhaler is empty and should be disposed of.

Other side effects include:
Very common (may affect more than 1 in 10 people)

This leaflet does not contain the complete information about your medicine. If you have any
questions, or are not sure about something, ask your doctor or pharmacist who have access to
additional information.

Common (may affect up to 1 in 10 people)


thrush in the mouth and throat

sore tongue or throat
hoarseness of voice

Flixotide Accuhaler is manufactured by: Glaxo Wellcome Production, Zone Industrielle No. 2,
23 Rue Lavoisier, 27000 Evreux, France.

Problems with your mouth and throat can be reduced by doing certain things straight after
inhaling your dose. These are brushing your teeth, rinsing your mouth or gargling with water
and spitting it out. Tell your doctor if you have these problems with your mouth or throat, but
do not stop treatment unless you are told to.

Procured from within the EU and repackaged by: Doncaster Pharmaceuticals Group Ltd.,
Kirk Sandall, Doncaster, DN3 1QR.

The following side effects have also been reported in patients with Chronic Obstructive
Pulmonary Disease (COPD):
• Pneumonia and bronchitis (lung infection). Tell your doctor if you notice any of the following
symptoms: increased sputum production, change in sputum colour, fever, chills, increased
cough, increased breathing problems
• Bruising.

PL No: 08929/0102

Product Licence holder: BR Lewis Pharmaceuticals Ltd., Kirk Sandall, Doncaster, DN3 1QR.

Leaflet revision and issue date (Ref.): 18.10.17
Flixotide™ and Accuhaler™ are trademarks of GlaxoSmithKline group of companies.

Rare (may affect up to 1 in 1,000 people)

thrush (candidiasis) in the oesophagus.

Very rare (may affect up to 1 in 10,000 people)

sleeping problems or feeling worried, over-excited and irritable. These effects are more
likely to occur in children
joint pains
level of sugar (glucose) in your blood may be increased
the way steroids are produced by your body may be affected when using Flixotide
Accuhaler. This is more likely to happen if you use high doses for a long period of time. This
can cause:
• children and young people to grow more slowly
• something called ‘Cushing’s syndrome’. This happens when you have too much steroid in
your body and it can cause thinning of your bones and eye problems (such as cataracts
and glaucoma which is high pressure in the eye).
Your doctor will help stop this happening by making sure you use the lowest dose of steroid
which controls your symptoms.

Blind or partially sighted?
Is this leaflet hard to see or read?
Call +44 (0) 1302 365000 (Regulatory)
Please be ready to give the following
Product name:
Flixotide 250 micrograms Accuhaler
Reference No:08929/0102

Although the frequency is not known, the following side effects may also occur:


depression, feeling restless or nervous. These effects are more likely to occur in children.
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